Chapter 26-PEDIATRIC ABDOMEN-JAUNDICE Flashcards
describes the absence or deficiency of bile secretion or failure of the bile to enter the alimentary tract (i.e., secondary to obstruction); the stool is claylike and colorless
Acholic
inflammation of appendix
appendicitis
fecalith or calcification located within the appendix; echogenic
appendicolith
congenital absence or closure of a normal body opening or tubular structure
atretic
hereditary disorder transmitted as an autosomal recessive trait; clinical manifestations include umbilical hernia (exomphalos), macroglossia, and gigantism, often accompanied by visceromegaly and dysplasia of the renal medulla; also called exophthalmos-macroglossia-gigantism (EMG) syndrome
Beckwith-Wiedemann syndrome
closure or absence of some or all of the major bile ducts
biliary atresia
congenital cystic malformation of the common bile duct
choledochal cyst
excessive development of one side or one half of the body or an organ
hemihypertrophy
thickened muscle in the pylorus that prevents food from entering the duodenum; occurs more frequently in males
hypertrophic pyloric stenosis
thickened by absorption, evaporation, or dehydration
inspissated
occurs when bowel prolapses into distal bowel and is propelled in an antegrade fashion
intussusception
infant in first 28 days of life
neonate
a rapidly developing tumor of the kidney that usually occurs in children
Wilm’s tumor also known as nephroblastoma
a malignant hemorrhagic tumor principally consisting of cells resembling neuroblasts that give rise to cells of the sympathetic system (especially the adrenal medulla)
neuroblastoma
condition in pyloric stenosis in the neonatal period; after drinking, the infant experiences projectile vomiting secondary to the obstruction in the pylorus
projectile vomiting
located between the stomach and duodenum
pyloric canal
photographing the scintillations emitted by radioactive substances injected into the body; this test is used to determine the outline and function of organs and tissues in which the radioactive substance collects or is secreted
scintigraphy
frequently associated with sectional areas of the gastrointestinal tract; the muscle is hyperechoic, and the inner core is hypoechoic
target (donut) sign
Jaundice can be caused by which kinds of obstruction of flow?
intrahepatic or extrahepatic obstruction
What are the three most common causes of jaundice??
1) Hepatitis
2) Biliary Atresia
3) Choledochal Cyst
Hepatitis and Metabolic disease are what type of obstruction conditions
Intrahepatic (in liver)
Choledochal cyst, biliary atresia, and spontaneous perforation of bile ducts are what type of obstruction condition?
Extrahepatic
A liver infection that occurs within the first 3 months
Can caused by infections, idiopathic causes, metabolism errors, and metabolic disorders.
Neonatal Hepatitis
How does neonatal hepatitis reach the liver?
through the placenta via the vagina from infected maternal secretinos, catheters, or blood transfusions.
What does neonatal hepatitis look like on Ultrasound
- normal to enlarged
- echogenic w/ decreased visualization of portal venous structure
- small GB if the hepatocellular dysfunction is severe.
The narrowing or underdevelopment of the biliary ductal system
Most common form has an absent gallbladder
Biliary Atresia
Biliary Atresia is more common in ________.
Male/Female
Male
Clinical features in a neonate indicates what pathology
________
Persistent jaundice, acholic stools, dark urine, and distended abdomen
biliary atresia
A patient comes in and the scan shows a normal to enlarged liver, normal/increased echogenicity, change in GB size after drinking milk (suggests hepatic and CBD are patent)
What would this indicate?
Biliary Atresia
Abnormal cystic dilation of biliary tree that most commonly affects CBD
Choledochal Cyst
Patient comes in and clinically presents w/ jaundice and pain. She has a palpable mass in her RUQ. Ultrasound shows dilation of ductal system w/ a mass.
What would this indicate?
Choledochal cyst
What is the most common benign vascular tumor of early childhood that typically occurs within the first 6 months of life?
Infantile Hemangioendothelioma
Infantile hemangioendothelioma grows rapidly causing abdominal distention.
T/F
True
A patient comes in and presents clinically with hepatmegaly and elevated serum alpha-fetoprotein. Her abdomen is distended. Her ultrasound shows multiple hypoechoic lesions, calcification, and is well circumscribed.
What does she have, and how long will it take until it spontaneously regresses?
Infantile Hemangioendothelioma
What is the most common primary malignant disease of the liver that occurs frequently in children under 5 and most are under 2 years old?
Hepatoblastoma
What is the 3rd most common abdominal malignancy after Wilms Tumor?
Hepatoblastoma
_____ is considered the infant form of hepatocellular carcinoma and is associated with Beckwith-Wiedemann
Hepatoblastoma
A patient comes in and presents clinically with a palpable mass, elevated serum-alpha-fetoprotein, fever, pain and weight loss. When scanned, we find hepatomegaly w/ a solitary mass and calcification and portal vein thrombosis.
What does this patient have?
Hepatoblastoma
What is the 2nd most common malignant tumor in childhood in which half the children have preexisting liver disease?
Hepatocellular Carcinoma
Hepatocellular carcinoma presents as ??
multicentric solid mass w/o calcifications
Where is the pyloric canal located?
between the stomach and duodenum
Hypertrophic Pyloric Stenosis is more frequently in males between 2-6 weeks old?
True/False
True
What is the most common acute abdominal inflammatory process after gastroenteritis that occurs when appendiceal lumen becomes obstructed and infected?
Appendicitis
Clinical findings of RLQ and vomiting, fever and increased WBC
What could this indicate?
Appendicitis
Sonographically ___________ shows a non-compressible appendix, lack of peristalsis in appendix,,localized pain w/ transducer pressure and free fluid in lower abdomen.
Appendicitis
Most common acute abdominal disorder in early childhood that occurs when bowel prolapes into more distal bowel and is propelled antegrade
Intussusception
Intussusception is more common in females
T/F
FALSE
more common in males 2:1
